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. 2025 Aug 30.
doi: 10.1007/s13304-025-02267-1. Online ahead of print.

Conversion of sleeve gastrectomy to different types of bipartitions: OATB, B-TB, and RYTB-a retrospective single-center study

Vasiliki Christogianni  1 , Ashwini Rao  2 , Christian-Joern Halter  2 , Panagiotis Bemponis  2 , Mohanned Raed  2 , Osama E Zaidi  2 , Martin Buesing  2 , Markus Reiser  3
Affiliations

Conversion of sleeve gastrectomy to different types of bipartitions: OATB, B-TB, and RYTB-a retrospective single-center study

Vasiliki Christogianni et al. Updates Surg. .

Abstract

Introduction: As the prevalence of sleeve gastrectomy (SG) continues to rise each year, so does the number of patients requiring conversion to a hypoabsorptive procedure due to suboptimal results. While various types of bypass surgeries have been studied, available literature on transit bipartitions (TB) remains limited.

Methods: We conducted a retrospective analysis of patients who underwent conversion of SG to TB at our institution between November 1, 2017 and March 30, 2022. Three TB techniques were evaluated: one anastomosis sleeve-ileal TB (OATB), sleeve-ileal loop TB with Braun jejunoileostomy (B-TB), and TB with a Roux-en-Y formed small bowel short circuit (RYTB). Additional percentage of excess weight loss (%EWLadditional), percentage of total body weight loss (%TWL), and resolution of obesity-related comorbidities were the primary outcomes, while adverse effects were analyzed to assess the safety of each procedure.

Results: Of the 482 SG-to-TB conversions performed by March 2024, 171 patients with a complete follow-up (FU) of 2 years were included and matched by sex, age, and Body Mass Index (BMI) at the time of conversion. The %EWLadditional for OATB, B-TB, and RYTB at 2 years FU was 50.1, 53.4 and 54.3, respectively, with no significant differences in weight loss outcomes over time. OATB patients experienced more long-term adverse effects and showed a higher rate of reoperation.

Conclusiuon: TB after SG is a feasible and effective revisional procedure for achieving further weight loss and managing obesity-realated comorbidities. OATB, however, may be associated with a higher risk of long-term complications compared to other TB techniques.

Keywords: Conversion; Sleeve gastrectomy; Transit bipartition.

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Conflict of interest statement

Declarations. Conflict of Interest: The authors have nothing to disclose and no commercial associations that could be considered as a conflict of interest related to this article. Ethical approval: As stated in § 15 para 1 of the Professional Code of the Medical Association Westfalen-Lippe, to whom our institution is affiliated, and in aligment with the item 1 of the Declaration of Helsinki by the World Medical Association (Rev. 2013), Ethics Committee approval is not required for retrospective analyses derived from a pseudonymized database, which applies to our study. Written informed consent for all surgical procedures was obtained from each patient.

References

    1. Bray GA (2004) Obesity is a chronic, relapsing neurochemical disease. Int J Obes Relat Metab Diso rd 28(1):34–38. https://doi.org/10.1038/sj.ijo.0802479 . (PMID: 14557829) - DOI
    1. Brethauer SA, Kothari S, Sudan R, Williams B, English WJ, Brengman M, Kurian M, Hutter M, Stegemann L, Kallies K, Nguyen NT, Ponce J, Morton JM (2014) Systematic review on reoperative bariatric surgery: American Society for Metabolic and Bariatric Surgery Revision Task Force. Surg Obes Relat Dis. 10(5):952–972. https://doi.org/10.1016/j.soard.2014.02.014 . (Epub 2014 Feb 22. PMID: 24776071) - DOI - PubMed
    1. Biertho L, Thériault C, Bouvet L, Marceau S, Hould FS, Lebel S et al (2018) Second-stage duodenal switch for sleeve gastrectomy failure: a matched controlled trial. Surg Obes Relat Dis. 14(10):1570–1579. https://doi.org/10.1016/j.soard.2018.05.008 . (PubMed PMID: 30449513) - DOI - PubMed
    1. Cheung D, Switzer NJ, Gill RS, Shi X, Karmali S (2014) Revisional bariatric surgery following failed primary laparoscopic sleeve gastrectomy: a systematic review. Obes Surg 24(10):1757–1763. https://doi.org/10.1007/s11695-014-1332-9 . (PubMed PMID: 24927693) - DOI - PubMed
    1. Zadeh JR, Alvarez R, Khaitan L, Abbas M (2023) Conversion of gastric sleeve to Roux-en-Y gastric bypass: overall outcomes and predictors of below-average weight loss. Surg Obes Relat Dis. 19(2):111–117. https://doi.org/10.1016/j.soard.2022.10.029 . (PubMed PMID: 36470814) - DOI - PubMed

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